MarioF.Romagnoli-1993 The literature does not seem to support any increased incidence of nasal or paranasal colonization or infection with fungi, although we have recently seen a healthy, immunocompetent man who presented with diplopia and sphenoid mass lesion. A. T. Henrici - 1939 In man and mammals fungal infections are so rare as to be of little practical importance
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MarioF.Romagnoli-1993The literature does not seem to support any increased incidence of nasal or paranasal colonization or infection with fungi, although we have recently seen a healthy, immunocompetent man who presented with diplopia and sphenoid mass lesion.
A. T. Henrici - 1939
In man and mammals fungal infections are so rare as to be of little practical importance
FUNGAL SINUSITIS
Dr. Ajay George
Goals of today’s class TO GET ATTENDANCE. To understand the pathogenesis of fungal
sinusitis. To know about the causative agents. To know the principles of treatment.
Predisposing Factors:
•Uncontrolled diabetics.
•Chronic renal failure.
•Immuno compromised patients.
HIV
Leukaemias
Drugs
Chronic debilitating illness.
Conidiobolus coronatus(Rhinophycomycosis)
Cases seen in Central Africa, Brazil, West Indies.
Presents as polyps/ granulomas. Lesions spread submucosally. Treatment is removal of mass & amphotericin.
Rhinocerebral phycomycosis
Caused by Rhizopus oryzae, Mucor javanicus, Mucor circinelloides, Absidia corymbitera.
Usually a saprophyte. Marked affinity for blood vessels. Involves Nose, PNS, Orbit, Brain. Disease is confirmed by biopsy. Local drainage & debridement & Amphotericin
Aspergillosis
Caused by A. fumigatus, A. niger, A. flavus. Causes all forms of fungal sinusitis. Diagnosis is from fresh scrappings, Treatment depends on manifestation.
Blastomycosis
Caused by thermally diamorphic fungus Blastomyces dermatidis.
Common in North America – Ohio & Mississippi river valley areas.
Confirmation by special staining and serology. It is rarely fatal. Treatment depends on severity.
Cryptococcosis
Caused by Cryptococcus neoformans. Found in avian excreta. Predeliction for lung and brain. Usually completely treatable.
Actinomycosis
Actinomyces israelii is pathogenic for humans. Trauma predisposes for pathogenicity. Treatment is high dose penicillin.
Candidiasis
Caused by Candida albicans. Presents as small, discrete, pearly or dirty white
patches on red moist mucous membrane which can be easily removed without bleeding.
Treatment is by local application of 1% aqueous gentian violet or nystation.
Histoplasmosis
Caused by Histoplasma capsulatum. Common in central USA. Diagnosis is by biopsy and histoplasmin skin
test. Treatment is by amphotericin.
Sporotrichosis
Caused by Sporothrix schenckii. Infection of mucosa is usually by implantation. Treatment is by iodides or amphotericin.